高负荷剂量卡泊芬净治疗ICU重症患者侵袭性真菌感染的疗效分析  

Effect of high loading dose of caspofungin in the treatment of ICU severe patients with invasive fungal infection

作　　者：王华杰[1] 朱永[1] 苏醒[1] 麦叶[1] 陈东娇[1] 

机构地区：[1]海南省人民医院重症医学科,海南海口570301

出　　处：《中华医院感染学杂志》2016年第14期3222-3224,共3页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(814322)

摘　　要：目的探讨高负荷剂量卡泊芬净治疗ICU重症患者侵袭性真菌感染的疗效。方法选取医院2014年4月-2015年9月ICU收治78例ICU重症侵袭性真菌感染患者为研究对象,采用随机数字表法分为观察组和对照组各39例,观察组施行高负荷(首次100mg)剂量卡泊芬净进行治疗,对照组施行常规剂量(首次70mg)卡泊芬净进行治疗,观察两组患者治疗效果及不良反应发生率。结果两组患者共检测出115株真菌,观察组真菌清除率为74.6%明显高于对照组53.8%(P<0.05);观察组治疗的总有效率87.3%明显高于对照组58.9%(P<0.05);治疗前后两组患者的肝肾功能比较差异均无统计学意义;两组患者的耐受性均良好,均无呕吐、疼痛及腹泻现象发生,在皮疹、贫血等不良反应发生率方面两组比较差异无统计学意义。结论高负荷剂量卡泊芬净治疗ICU重症患者侵袭性真菌感染的效果明显,安全可靠,值得临床推广应用。OBJECTIVE To explore the effect of high loading dose of caspofungin in the treatment of ICU severe patients with invasive fungal infection.METHODS Totally 78 cases of ICU severe patients with invasive fungal infection in department of ICU in our hospital from Apr.2014 to Sep.2015 were selected as the research objects,which were divided into the observation group and the control group by the random number table method with 39 cases in each group.The observation group was given high loading dose of caspofungin treatment（firstly 100mg）,and the control group was given conventional dose of caspofungin treatment（firstly 70mg）.The treatment effect and rates of adverse reaction of patients in the two groups were observed.RESULTSIn the two groups of patients,a total of 115 fungal strains were detected,and the fungal clearance rate of the observation group was 74.6%,which was significantly higher than 53.8%of the control group（P〈0.05）.The total effective rate of the observation group was 87.3%,which was significantly higher than that of 58.9%in the control group（P〈0.05）.There were no significant differences of liver and kidney functions between the two groups before and after treatment.The patients in the two groups were well tolerated,without vomiting,pain and diarrhea,and the rates of adverse reactions such as skin rash,anemia,and other adverse reactions were not significantly different in the two groups.CONCLUSIONThe therapeutic effects of high loading dose of caspofungin in the treatment of ICU severe patients with invasive fungal infection are obvious,safe and reliable,which is worthy of clinical popularization and utilization.

关 键 词：高负荷剂量 卡泊芬净 ICU重症患者 真菌感染 

分 类 号：R372[医药卫生—病原生物学]